The number of Americans adopting gluten-free diets has grown dramatically over the past several years. Some avoid eating wheat, barley, and rye because they have an autoimmune disorder called celiac disease, some are sensitive to gluten which can cause stomach upset, and others simply avoid gluten in an effort to lose weight. While many feel the diet has improved their overall health, are there potential downsides to abstaining from gluten?

UConn Today recently discussed going gluten-free with Dr. Haleh Vaziri, gastroenterologist at UConn Health in the Division of Gastroenterology and Hepatology. Vaziri is board-certified in internal medicine and gastroenterology and diagnoses and treats a wide range of gastrointestinal issues, including celiac disease and problems related to food sensitivities.

What is gluten?

Gluten is the portion of the protein component of wheat that forms the structure of dough. It gives dough its sticky and pliable consistency.

What is celiac disease?

Celiac disease is an autoimmune digestive disease with permanent intolerance to gluten in wheat, rye, and barley. In celiac disease, gluten causes damage to the small intestine, and this affects its ability to absorb nutrients.

What are some symptoms of celiac disease?

Abdominal pain, bloating, diarrhea, anemia, irritability, mouth ulcers, an itchy skin rash.

The number of people suffering from celiac disease or gluten sensitivity seems to be increasing – why is that?

There are different hypotheses: 1) The disease may have been under-diagnosed in the past. 2) Our environment today is much too clean and the human immune system has few things to battle and therefore starts attacking itself. 3) The wheat today may be different than wheat years ago because of hybridization, and therefore elicits an immune response when consumed.

Is there any downside to following a gluten-free diet if you don’t have celiac disease or a gluten-sensitivity?

By law, wheat flour must be enriched and fortified whereas other non-wheat flour products are not required to do so. There is no harm in eating gluten-free; however, a gluten-free diet may lack certain nutrients that are found in fortified wheat products, including vitamin B1, B2, B3, and (Iron) Fe.

There is also the possibility of weight gain, if gluten-containing food is replaced with fatty food.

Do you think going gluten-free is just another food fad?

Gluten is only harmful if you have a gluten allergy and/or celiac disease. There are some people who report feeling better on a gluten-free diet without having celiac disease.

Possible reasons for this include 1) a placebo effect; 2) elimination of another food component along with gluten; or 3) a real intolerance of gluten, other than celiac disease.

Another factor to keep in mind is that the gluten-free diet is more expensive.